Fine needle aspiration cytology (FNAC) plays important role in diagnosis of thyroid lesions. However conventional reporting of cytology lack standardize format. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) presented at Bethesda in 2007 to address this barrier and facilitate communication between cytopathology’s and clinician. This study was designed to classify thyroid FNAC according to TBSRTC, calculate malignancy risk by analytical cross sectional study. All the FNAC of thyroid lesions came during August 2013 to December 2014 were classified in to six categories of TBSRTC. Distribution of cases in each category was calculated. Cytopathology examination carried out whenever tissue was available and malignancy risk calculated. A total number 115 patients was enrolled to this study, 96 (83.48%) females and 19 (16.52%) males. The patients’ ages ranged from 17 years to 80 years. The highest prevalence was noted in age groups 41-50 years followed with age groups 31-40 years with for both genders. All FNAS results were classified in to six categories of TBSRTC. The highest prevalence was recorded with benign with 51.3%, followed by A.U.S with 14.7% then U.N.S with 11.3%. Use of TBSRTC for thyroid FNAC reporting helps to highlight increased malignancy risk associated with different classification and malignant categories related to cytology of thyroid lesions.